Provider Demographics
NPI:1023006012
Name:EHLERS, MICHAEL D (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:EHLERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:125 LAWRENCE BELL DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7817
Mailing Address - Country:US
Mailing Address - Phone:716-634-4679
Mailing Address - Fax:716-634-5415
Practice Address - Street 1:800 HARLEM RD
Practice Address - Street 2:SUITE 400
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-1083
Practice Address - Country:US
Practice Address - Phone:716-824-5857
Practice Address - Fax:716-824-5890
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0398291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00941891Medicaid